While a third of the U.S. population may be pre-diabetic, only 10 percent know they are at risk. Its symptoms are far-ranging, but too much sugar—even natural sugar—and processed foods are at the heart of the problem.

Did you know at least one-third of Americans are at imminent risk of becoming diabetic?

If you experience food cravings, mood swings, anxiety and depression, irritability and/or fatigue, you might unknowingly be at risk. The scary truth is, even a “healthy” diet can put you in the danger zone.

You may have heard that diabetes is climbing at an alarming rate. But staying out of the diabetic range is not enough—high blood sugar, even within the so-called “normal range,” has been shown to increase the risk of dying of a heart attack or stroke by 40%, as well as chronic diseases such as cancer, cardiovascular disease, Alzheimer’s, kidney disease, and neuropathy (2).

In this first installment of our series on pre-diabetes, join me as I delve into why and how this silent killer develops, and why most people that already have it, don’t know it. Most importantly, I will offer the real-life strategies that have helped stave off and even reverse pre-diabetes for my patients.

It’s important to understand why and how blood sugar rises, and how common, even “healthy” diets, can prompt the progression of pre-diabetes:

As sugars—even “natural sugars”—and simple carbohydrates are digested, they force the pancreas to produce excess insulin, which is needed to escort the sugars out of the bloodstream and into the cells.

Over time, when the insulin levels are driven up again and again several times a day, the pancreas becomes worn out and the cells can become resistant to taking in any more sugar.

Excess sugar in the blood, unable to be absorbed by the cells, keeps the blood sugar unnaturally high. It lingers there until the insulin stores it as fat, often (but not always) causing abdominal fat, obesity, and high cholesterol.

Excess blood sugar also attaches to proteins that may damage or thicken the arterial wall, directly increasing the risk of cardiovascular disease (2), clots, inflammation, cancer, heart attack and stroke, and more (4).

Most People Who Have Pre-Diabetes Don’t Know It

Here are some staggering statistics: while one third of the American population currently qualifies as Pre-Diabetic, an incredible 90% of them do not know it (9).

Moreover, many of them maintain what would commonly be considered a “healthy” diet.

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